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Toktas N, Duruturk N, Güzel Ş, Yürük Ö, Özen S. The effect of transcranial direct current stimulation on balance, gait function and quality of life in patients with stroke. Neurol Res 2024:1-8. [PMID: 38825035 DOI: 10.1080/01616412.2024.2362583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 05/27/2024] [Indexed: 06/04/2024]
Abstract
Transcranial direct current stimulation (tDCS) has been used in various neurological diseases due to its positive effects on cortical excitability. The aim of our study is to examine the effects of tDCS in stroke and 28 patients with stroke were randomly divided into two groups as intervention and control groups. Balance was evaluated with the Timed Up and Go Test and Berg Balance Scale. Walking functions were evaluated using the 10-meter Walk Test and the 6 Minutes Walk Test, lower extremity function was evaluated by Fugl Meyer Lower Extremity Scale, quality of life by Stroke-Specific Quality of Life Scale (SS-QOL). A task-oriented physiotherapy and rehabilitation program was applied to both groups. In addition to the task-oriented program, anodal tDCS was applied in the intervention group and carried out with a current of 2 mA, 5 days a week, 20 min, for a total of 4 weeks. In the control group, after the flow was opened for 30 s and the patient felt a tingling sensation, it was turned off without the patient noticing. As a result, significant improvement was obtained in all parameters in both groups (p < 0.05). At the difference values of both groups, only SS-QOL mobility subgroup was significant and other parameters were not significant. Considering all these results, it can be seen that tDAS applied in addition to the task-oriented training program in individuals with stroke makes a positive contribution to the patients' balance, walking function and quality of life. We think that tDAS may be a feasible and safe additional approach in this patient group.
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Affiliation(s)
- Nehir Toktas
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Baskent University, Ankara, Turkey
| | - Neslihan Duruturk
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Baskent University, Ankara, Turkey
| | - Şükran Güzel
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Baskent University, Ankara, Turkey
| | - Özlem Yürük
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Baskent University, Ankara, Turkey
| | - Selin Özen
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Baskent University, Ankara, Turkey
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Baik JS, Yang JH, Ko SH, Lee SJ, Shin YI. Exploring the Potential of Transcranial Direct Current Stimulation for Relieving Central Post-Stroke Pain: A Randomized Controlled Pilot Study. Life (Basel) 2023; 13:life13051172. [PMID: 37240817 DOI: 10.3390/life13051172] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/08/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
The potential of transcranial direct current stimulation (tDCS) as a non-invasive brain stimulation technique for treating pain has been studied. However, its effectiveness in patients with central post-stroke pain (CPSP) and the impact of lesion location remain unclear. This study investigated tDCS's pain reduction effects in patients with CPSP. Twenty-two patients with CPSP were randomized into the tDCS or sham groups. The tDCS group received stimulation of the primary motor cortex (M1) for 20 min, five times weekly, for two weeks, and underwent evaluations at baseline, immediately after the intervention, and one week after the intervention. The tDCS group had no significant improvement compared to the sham group in pain, depression, and quality of life. Nevertheless, significant changes were identified within the tDCS group, and the pain trends appeared to be influenced by the lesion location. These findings provide important insights into the use of tDCS in patients with CPSP, which could inform further research and development of pain treatment options.
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Affiliation(s)
- Ji-Soo Baik
- Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Jung-Hyun Yang
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Sung-Hwa Ko
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Rehabilitation Medicine, The Graduate School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea
| | - So-Jung Lee
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
| | - Yong-Il Shin
- Department of Rehabilitation Medicine, Pusan National University Yangsan Hospital, Yangsan 50612, Republic of Korea
- Department of Rehabilitation Medicine, The Graduate School of Medicine, Pusan National University, Yangsan 50612, Republic of Korea
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Hao W, Liu Y, Gao Y, Gong X, Ning Y. Transcranial direct current stimulation for the treatment of post-stroke depression: A systematic review. Front Neurol 2023; 13:955209. [PMID: 36742053 PMCID: PMC9893893 DOI: 10.3389/fneur.2022.955209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 12/22/2022] [Indexed: 01/20/2023] Open
Abstract
Background Post-stroke depression (PSD) is not only a frequent neuropsychiatric manifestation secondary to stroke but is also associated with disability, poor rehabilitation outcomes, sleep disorders, cognitive impairment, and increased mortality. Transcranial direct current stimulation (tDCS), a primary modality of non-invasive brain stimulation (NIBS), has shown promising clinical results in the rehabilitation of patients with PSD recently. The primary aim of this systematic review is to assess the effects of tDCS on PSD. Methods PubMed and Cochrane databases were used for paper identification up to May 2022. Only English language studies and published data were taken into consideration. The methodological quality of selected studies was assessed according to the modified Sackett Scale, based on Physiotherapy Evidence Database (PEDro) scores. Results Six experimental studies were included for the PSD treatment of tDCS and all of them reported that, following the intervention of tDCS, the experimental group shows a statistically significant decrease in the depression level in accordance with different assessment scales. Conclusion This article simply aims at providing a comprehensive overview of the raw data reported in this field to date. Based on the current evidence, tDCS presents promising results for the treatment of PSD. Moreover, tDCS is also effective in PSD patients with aphasia or CPSP. However, an optimal stimulation protocol is needed to formulate. Thus, the development of robustly controlled, randomized, and high-quality clinical trials to further assess the utility of tDCS as a therapeutic tool for the treatment of PSD survivors is encouraged. Systematic review registration https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42023322076, identifier: CRD42023322076.
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Affiliation(s)
- Wenjian Hao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China,Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
| | - Yong Liu
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China,Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China,*Correspondence: Yong Liu ✉
| | - Yuling Gao
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Xiaoyang Gong
- Department of Rehabilitation Medicine, The First Affiliated Hospital of Dalian Medical University, Dalian, China
| | - Yi Ning
- Institute (College) of Integrative Medicine, Dalian Medical University, Dalian, China
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Ethridge VT, Gargas NM, Sonner MJ, Moore RJ, Romer SH, Hatcher-Solis C, Rohan JG. Effects of transcranial direct current stimulation on brain cytokine levels in rats. Front Neurosci 2022; 16:1069484. [PMID: 36620466 PMCID: PMC9822516 DOI: 10.3389/fnins.2022.1069484] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Accepted: 12/05/2022] [Indexed: 01/05/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) has shown therapeutic potential to mitigate symptoms of various neurological disorders. Studies from our group and others used rodent models to demonstrate that tDCS modulates synaptic plasticity. We previously showed that 30 min of 0.25 mA tDCS administered to rats induced significant enhancement in the synaptic plasticity of hippocampal neurons. It has also been shown that tDCS induces expression of proteins known to mediate synaptic plasticity. This increase in synaptic plasticity may underly the observed therapeutic benefits of tDCS. However, the anti-inflammatory benefits of tDCS have not been thoroughly elucidated. Here we report that three sessions of tDCS spaced 1-3 weeks apart can significantly reduce levels of several inflammatory cytokines in brains of healthy rats. Rats receiving tDCS experienced enhanced synaptic plasticity without detectable improvement in behavioral tests or significant changes in astrocyte activation. The tDCS-mediated reduction in inflammatory cytokine levels supports the potential use of tDCS as a countermeasure against inflammation and offers additional support for the hypothesis that cytokines contribute to the modulation of synaptic plasticity.
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Affiliation(s)
- Victoria T. Ethridge
- Naval Medical Research Unit Dayton (NAMRU-D), Wright-Patterson Air Force Base, Dayton, OH, United States,Odyssey Systems Consulting Group, Wakefield, MA, United States,Leidos, Reston, VA, United States
| | - Nathan M. Gargas
- Naval Medical Research Unit Dayton (NAMRU-D), Wright-Patterson Air Force Base, Dayton, OH, United States,Odyssey Systems Consulting Group, Wakefield, MA, United States,Leidos, Reston, VA, United States
| | - Martha J. Sonner
- Naval Medical Research Unit Dayton (NAMRU-D), Wright-Patterson Air Force Base, Dayton, OH, United States,Leidos, Reston, VA, United States,ICON, Hinckley, OH, United States
| | - Raquel J. Moore
- Infoscitex, Dayton, OH, United States,711th HPW/RHBCN, Wright-Patterson Air Force Base, Dayton, OH, United States
| | - Shannon H. Romer
- Naval Medical Research Unit Dayton (NAMRU-D), Wright-Patterson Air Force Base, Dayton, OH, United States,Odyssey Systems Consulting Group, Wakefield, MA, United States,Leidos, Reston, VA, United States
| | | | - Joyce G. Rohan
- Naval Medical Research Unit Dayton (NAMRU-D), Wright-Patterson Air Force Base, Dayton, OH, United States,*Correspondence: Joyce G. Rohan,
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Li Y, Li HP, Wu MX, Wang QY, Zeng X. Effects of transcranial direct current stimulation for post-stroke depression: A systematic review and meta-analysis. Clin Neurophysiol 2022; 142:1-10. [DOI: 10.1016/j.clinph.2022.07.369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 04/05/2022] [Accepted: 07/09/2022] [Indexed: 12/24/2022]
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Machine learning predicts clinically significant health related quality of life improvement after sensorimotor rehabilitation interventions in chronic stroke. Sci Rep 2022; 12:11235. [PMID: 35787657 PMCID: PMC9253044 DOI: 10.1038/s41598-022-14986-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/16/2022] [Indexed: 12/04/2022] Open
Abstract
Health related quality of life (HRQOL) reflects individuals perceived of wellness in health domains and is often deteriorated after stroke. Precise prediction of HRQOL changes after rehabilitation interventions is critical for optimizing stroke rehabilitation efficiency and efficacy. Machine learning (ML) has become a promising outcome prediction approach because of its high accuracy and easiness to use. Incorporating ML models into rehabilitation practice may facilitate efficient and accurate clinical decision making. Therefore, this study aimed to determine if ML algorithms could accurately predict clinically significant HRQOL improvements after stroke sensorimotor rehabilitation interventions and identify important predictors. Five ML algorithms including the random forest (RF), k-nearest neighbors (KNN), artificial neural network, support vector machine and logistic regression were used. Datasets from 132 people with chronic stroke were included. The Stroke Impact Scale was used for assessing multi-dimensional and global self-perceived HRQOL. Potential predictors included personal characteristics and baseline cognitive/motor/sensory/functional/HRQOL attributes. Data were divided into training and test sets. Tenfold cross-validation procedure with the training data set was used for developing models. The test set was used for determining model performance. Results revealed that RF was effective at predicting multidimensional HRQOL (accuracy: 85%; area under the receiver operating characteristic curve, AUC-ROC: 0.86) and global perceived recovery (accuracy: 80%; AUC-ROC: 0.75), and KNN was effective at predicting global perceived recovery (accuracy: 82.5%; AUC-ROC: 0.76). Age/gender, baseline HRQOL, wrist/hand muscle function, arm movement efficiency and sensory function were identified as crucial predictors. Our study indicated that RF and KNN outperformed the other three models on predicting HRQOL recovery after sensorimotor rehabilitation in stroke patients and could be considered for future clinical application.
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Shen Y, Cai Z, Liu F, Zhang Z, Ni G. Repetitive Transcranial Magnetic Stimulation and Transcranial Direct Current Stimulation as Treatment of Poststroke Depression: A Systematic Review and Meta-Analysis. Neurologist 2022; 27:177-182. [PMID: 35184118 DOI: 10.1097/nrl.0000000000000416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Previous studies showed that the application of repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) during stroke rehabilitation improve the depression symptoms in poststroke depression (PSD). However, some studies showed inconsistent results. The study was designed to make a meta-analysis to evaluate the effect of noninvasive brain stimulation (tDCS and rTMS) on PSD. METHODS Articles published before July 2021 were searched in databases: PubMed, Web of Science, and Google Scholar. STATA 12.0 software was utilized to make meta-analysis. We extracted or calculated mean values and SD of reduction or increase rate of depression-related scales. Standardized mean difference (SMD) and 95% confidence intervals (CIs) were calculated as effect size. RESULTS The study showed increased immediate and long-term improvement in depression in rTMS group compared with sham rTMS group after treatment with random-effects models (immediate: SMD=4.92, 95% CI=2.69-7.15, I2 =95.2%, P -value for Q test <0.001; long term: SMD=7.21, 95% CI=3.50-10.92, I2 =93.9%, P -value for Q test <0.001). Meta-analysis showed increased substantially immediate improvement in depression in tDCS group compared with sham tDCS group with a random effect model (SMD=5.30, 95% CI=1.30-9.30, I2 =97.3%, P- value for Q test <0.001). CONCLUSIONS rTMS and tDCS were demonstrated to be effective and safe treatment techniques for PSD. More large-scale studies were essential to explore the effect of rTMS with different frequencies and tDCS on PSD.
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Affiliation(s)
- Yiting Shen
- College of Acupuncture-Moxibustion and Tuina, Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, China
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Rezakhani S, Amiri M, Weckhuysen S, Keliris GA. Therapeutic efficacy of seizure onset zone-targeting high-definition cathodal tDCS in patients with drug-resistant focal epilepsy. Clin Neurophysiol 2022; 136:219-227. [DOI: 10.1016/j.clinph.2022.01.130] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 01/15/2022] [Accepted: 01/20/2022] [Indexed: 12/27/2022]
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Sharafi E, Taghva A, Arbabi M, Dadarkhah A, Ghaderi J. Transcranial Direct Current Stimulation for Treatment-Resistant Major Depression: A Double-Blind Randomized Sham-Controlled Trial. Clin EEG Neurosci 2019; 50:375-382. [PMID: 31304775 DOI: 10.1177/1550059419863209] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In the current study, we tried to evaluate the effect of transcranial direct current stimulation (tDCS) on treatment-resistant major depression. We carried out a double-blind randomized sham-controlled trial was conducted in University Hospitals. Individuals with less than 50% decrease in the intensity of depression after 8 weeks of treatment with selective serotonin reuptake inhibitors were recruited. Thirty patients (16 women) with a mean (SD) age of 47.2 (12.0) years were randomly allocated to 2 groups. For the active group we administered 2-mA stimulation 20 minutes for each session, with 30 seconds ramp-up from 0 and 30 seconds ramp-down. For the sham group we administered 30 seconds ramp-up to 2 mA, 10 seconds stimulation, 30 seconds ramp-down, and 20 minutes no current. The anode was fixed on the center of F3, and the cathode on F4, over the dorsolateral prefrontal cortex. We assessed the Hamilton Depression Rating Scale at the baseline (mean difference = 1.0, P = .630), at the last session of tDCS, and at 1-month postintervention. There were statistically significant differences in the mean Hamilton scores after the intervention, and 1 month later in favor of active group; P < .001, and P = .003, respectively. Mixed analysis of variance showed a significant difference in the mean scores for active group P = .010 and pattern of change during the study P < .001 in favor of active intervention. We concluded that tDCS is an efficient therapy for patients with resistant major depression, and the benefits would remain at least for 1 month.
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Affiliation(s)
- Elham Sharafi
- 1 Department of Psychiatry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Arsia Taghva
- 2 Department of Psychiatry, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Mohammad Arbabi
- 1 Department of Psychiatry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Afsaneh Dadarkhah
- 3 Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Aja University of Medical Sciences, Tehran, Islamic Republic of Iran
| | - Jamshid Ghaderi
- 4 Tehran University of Medical Sciences, Roozbeh Hospital, Tehran, Islamic Republic of Iran
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de Souza JA, Corrêa JCF, Agnol LD, Dos Santos FR, Gomes MRP, Corrêa FI. Effects of transcranial direct current stimulation on the rehabilitation of painful shoulder following a stroke: protocol for a randomized, controlled, double-blind, clinical trial. Trials 2019; 20:165. [PMID: 30876431 PMCID: PMC6419802 DOI: 10.1186/s13063-019-3266-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 02/27/2019] [Indexed: 12/02/2022] Open
Abstract
Background Shoulder pain is reported to be one of the major challenges faced in the functional recovery of patients in rehabilitation following a stroke. In such cases, transcranial direct current stimulation (tDCS) has been used as an additional therapeutic tool for improvements in central and peripheral pain. The aim of the proposed study is to evaluate the effect of tDCS when combined with upper limb physical therapy on pain intensity and functional improvement in stroke survivors with shoulder pain in the hemiplegic limb. Methods A randomized, placebo-controlled, double-blind, clinical trial is proposed. The volunteers will be randomly allocated to receive passive movement on the upper limb, which will be performed by the therapist for 20 min followed by either active tDCS or sham tDCS (current stimulation for 30 s) during simultaneous physical activity of the upper limb (“mini-bike”) for 20 min, totaling 40 min of intervention performed in 10 consecutive sessions. The anode electrode will be positioned over the primary motor cortex with a current of 2 mA and the cathode electrode will be positioned in the supraorbital region contralateral to the anode. The primary outcome will be shoulder pain intensity, which will be measured using the visual analog scale (VAS) on three occasions: 1) pre-intervention; 2) after 10 interventions (5 weekly sessions, for 2 weeks); and 3) 30 days after the end of the interventions. The secondary outcomes will be motor performance, upper limb function, and quality of life. Trial registration Brazilian Registry of Clinical Trials, RBR-8F5MNY. Registered on June 2, 2017. Electronic supplementary material The online version of this article (10.1186/s13063-019-3266-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Janaina Andressa de Souza
- Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), Avenida Angélica, 1905-Apt161, São Paulo, SP, Brasil.
| | - João Carlos Ferrari Corrêa
- Postgraduate program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
| | - Letizzia Dall' Agnol
- Undergraduate course in Physical Therapy, Universidade Nove de Julho (UNINOVE), São Paulo, Brazil
| | | | | | - Fernanda Ishida Corrêa
- Postgraduate program in Rehabilitation Sciences, Universidade Nove de Julho (UNINOVE), São Paulo, SP, Brazil
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Jones M, Corcoran A, Jorge RE. The psychopharmacology of brain vascular disease/poststroke depression. PSYCHOPHARMACOLOGY OF NEUROLOGIC DISEASE 2019; 165:229-241. [DOI: 10.1016/b978-0-444-64012-3.00013-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
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Bucur M, Papagno C. A systematic review of noninvasive brain stimulation for post-stroke depression. J Affect Disord 2018; 238:69-78. [PMID: 29860185 DOI: 10.1016/j.jad.2018.05.026] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 04/09/2018] [Accepted: 05/16/2018] [Indexed: 12/25/2022]
Abstract
BACKGROUND Post-stroke depression (PSD) is among the most frequent neuropsychiatric consequences of stroke, negatively affecting the patient's functional recovery and the quality of life. While pharmacological therapy has limited efficacy and important side effects, new appropriate treatments based on specific physiological mechanisms for PSD remain to be developed. Non-invasive brain stimulation (NIBS) techniques, modulating brain plasticity, might offer valid, alternative strategies. METHODS We systematically searched four databases: MEDLINE, PsycARTICLES, PsycINFO and Web of Science, up to December 2017, using definite keywords, to identify studies on TMS and tDCS treatment for PSD. RESULTS Seven studies met the inclusion criteria and the results indicate that both tDCS and rTMS are safe and have very low side effects. The reported positive results, suggesting that these methods can be considered effective therapeutic options, are questionable, and a general statement about their efficacy for PSD is premature due to small sample sizes, heterogeneous methodologies, lack of uniform diagnostic criteria, and divergent data. LIMITATIONS The selected articles suffer lack of information about quality of life and daily living performance measures; in addition, the number of randomized controlled trials is small. CONCLUSION (S) The aim of this review was to analyze current research in the clinical use of noninvasive brain stimulation (NIBS) in PSD treatment in order to verify whether there are alternative perspectives in the treatment of PSD. Given the present evidence, future research is needed to address methodological limitations and evaluate the long-term efficacy of these methods, alone and in combination with pharmacological treatment.
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Affiliation(s)
- Madalina Bucur
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Italy.
| | - Costanza Papagno
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Italy; Center for Neurocognitive Rehabilitation (CeRiN), Rovereto, Italy
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Van de Winckel A, Carey JR, Bisson TA, Hauschildt EC, Streib CD, Durfee WK. Home-based transcranial direct current stimulation plus tracking training therapy in people with stroke: an open-label feasibility study. J Neuroeng Rehabil 2018; 15:83. [PMID: 30227864 PMCID: PMC6145321 DOI: 10.1186/s12984-018-0427-2] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2017] [Accepted: 09/11/2018] [Indexed: 11/17/2022] Open
Abstract
Background Transcranial direct current stimulation (tDCS) is an effective neuromodulation adjunct to repetitive motor training in promoting motor recovery post-stroke. Finger tracking training is motor training whereby people with stroke use the impaired index finger to trace waveform-shaped lines on a monitor. Our aims were to assess the feasibility and safety of a telerehabilitation program consisting of tDCS and finger tracking training through questionnaires on ease of use, adverse symptoms, and quantitative assessments of motor function and cognition. We believe this telerehabilitation program will be safe and feasible, and may reduce patient and clinic costs. Methods Six participants with hemiplegia post-stroke [mean (SD) age was 61 (10) years; 3 women; mean (SD) time post-stroke was 5.5 (6.5) years] received five 20-min tDCS sessions and finger tracking training provided through telecommunication. Safety measurements included the Digit Span Forward Test for memory, a survey of symptoms, and the Box and Block test for motor function. We assessed feasibility by adherence to treatment and by a questionnaire on ease of equipment use. We reported descriptive statistics on all outcome measures. Results Participants completed all treatment sessions with no adverse events. Also, 83.33% of participants found the set-up easy, and all were comfortable with the devices. There was 100% adherence to the sessions and all recommended telerehabilitation. Conclusions tDCS with finger tracking training delivered through telerehabilitation was safe, feasible, and has the potential to be a cost-effective home-based therapy for post-stroke motor rehabilitation. Trial registration NCT02460809 (ClinicalTrials.gov).
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Affiliation(s)
- Ann Van de Winckel
- Division of Physical Therapy; Division of Rehabilitation Science, University of Minnesota, 420 Delaware Street SE (MMC388), Minneapolis, MN, 55455, USA.
| | - James R Carey
- Division of Physical Therapy; Division of Rehabilitation Science, University of Minnesota, 420 Delaware Street SE (MMC388), Minneapolis, MN, 55455, USA
| | - Teresa A Bisson
- Division of Physical Therapy, University of Minnesota, Minneapolis, MN, 55455, USA
| | - Elsa C Hauschildt
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, 55455, USA
| | | | - William K Durfee
- Department of Mechanical Engineering, University of Minnesota, Minneapolis, MN, 55455, USA
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